Category: Diets

While Laura Cipullo and the Laura Cipullo Whole Nutrition Team work on some new and exciting projects, you may notice less posts on the Eating and Living Moderately Blog. We have created a “blog shelf” below to keep you entertained and educated. Get caught up on the latest nutrition education by clicking on each year below. We will send you nutrition updates, but we will not be inundating your mailboxes on a weekly basis. If you want weekly “love” and inspiration, subscribe to our Mom Dishes It Out blog for weekly posts and recipes. Mom Dishes It Out provides expert advice from mom Registered Dietitians and mom Speech Pathologists on the “how to” of health promotion!

The EALM Blog Shelf

Please feel free to peruse our posts organized by year below. Or take a look at the categories listed at the bottom of the page to find a post in the desired.

Bring on the Vit. B12. Vit. B12 is generally not found in plant sources. Milk, Fortified breakfast cereals and nutritional yeast are vegetarian friendly form of this water-soluble vitamin needed for red blood cell synthesis.

There aren’t too many quality research studies reporting on the gluten-free diet and its efficacy for children with autism spectrum disorders. However, you definitely hear the media and parents supporting it. The latest solid research a.k.a. randomized double-blind study only had fifteen children with ASD. This particular study from 2006 looked at the effects of the gluten-free, casein-free diet on autistic symptoms and urinary peptide levels. Surprisingly, there were no statistically significant results, still leaving the need for more research and many parents without answers. When reading the overall research, it seems parents may notice behavioral changes but nothing consistent across the board and nothing significant enough to make the recommendation to follow this diet.

However, when you keep reading, the association between ASD and GI (gastrointestinal) complaints is quite clear. Adverse GI symptoms such as diarrhea and abdominal pain are reported from 9 to 91 percent in different study populations1. The cause of these GI problems is unclear, but it appears to relate partially to abnormal carbohydrate digestion1 and abnormal gut flora possibly due to excessive use of oral antibiotics2. If gut flora is a concern, probiotics may help decrease ASD symptoms.

As parents wait for more information, many are willing to try the variety of diets that promise decreased symptoms. Like any child, a child with ASD is an individual and may/may not respond to dietary changes. It could be like many other foods—there are intolerances or sensitivities not recognizable as food allergies. There are many questions for parents to ask themselves and/or their child’s team. Weigh the pros and cons and decide what you think is best for your child.

In the 70’s, we banned fat. In the 90’s we banned carbs – and neither really worked to improve our lifestyles and relationships with food. As new research comes out regarding the best ways to eat for a healthy body, heart health, brain health – you name it – our food industry adjusts accordingly to provide these foods for us to eat. But what if we simply had a neutral relationship with food and a positive relationship with eating? It seems we would be more likely to eat exactly what our bodies need and avoid the foods our bodies can do without.

Recently, an article was published in TIME Magazine with the title “EAT BUTTER.” There’s something that will catch the reader’s eye, but what is behind the cover? For over 40 years, Americans have been on a low-fat craze because it was believed to be the best way to preserve our hearts from heart disease. Turns out, the research was misleading and the way we interpreted the research was not any better for our bodies. According to Marion Nestle, professor of Nutrition, Food Studies and Public Health at New York University, ideally we thought “that if people reduced saturated fat, they would replace it with healthy fruits and vegetables.” What really happened was people replaced those calories with processed foods and snacks like low-fat cookies, cakes, crackers and more.

We started regaling fats as “good” fats and “bad” fats, and we did the same with cholesterol. Giving these positive and negative titles to foods can lead to overeating and or food avoidance. It is important to understand that fats, like all foods, are neutral. They are essential in our diet for brain health, blood sugar regulation and for keeping us feeling full. Carbs (sugar, fruits, vegetables, grains, dairy) are also essential in our diet for energy, fiber, vitamins and minerals. Avoiding one or the other can lead to undernourishment and side effects like fatigue and mood swings.

In 1996, Dr. Walter Willet published research concluding that removing fat from our diets and replacing that void with carbohydrates does not reduce our risk for heart disease. It just so happens that around the time this study was published, the Mediterranean diet started gaining popularity. All fats are important. All carbs are important. All proteins are important. There is actually research supporting Mediterranean diets with 40% fat. But the fat source is mainly monounsaturated fats. Remember, when you eat fats like dairy, oils, nuts, and so on, you are typically getting a bit of saturated and unsaturated fat. So while the jury is still out, stick with moderation and try to eat more wholesome nutrition the majority of the time.

Ultimately, the TIME article is not saying Americans should drop everything and start eating butter or loading up on saturated fat. The message seems to be implying that we should no longer be afraid of fat, and we can start incorporating all types of fat in moderation. It’s time we changed our thinking from exile to acceptance. Allowing ourselves to have access to all foods will decrease the desire to resist any particular nutrient or food group. We will all be healthier for it.

I know the new documentary Fed Up declares that scare tactics have worked for decreasing tobacco sales. Personally, I worry that scare tactics will actually contribute to more fat shaming, diet shaming and finger pointing.

I was really surprised that Katie Couric narrated this film directing negative attention toward Michelle Obama, food companies and one evil — sugar. My surprise is specific to Katie’s history of an eating disorder.

As a certified eating disorder specialist, I know and hope Katie knows that deprivation and shaming lead only to more binging, overeating and weight gain. This black and white delineation simply contributes to the eating disorder mentality.

In addition, I personally don’t think scaring people into not eating sugar is any better than scaring them into not eating fat back in the 80s. That particular scare tactic definitely didn’t work. We all got “fatter”.

If we isolate just one macronutrient, people will continue to eat it secretly. Meanwhile, food companies easily reformulate their products to meet the new standard. Scaring and blaming merely nurture the “poor health epidemic” we have today.

That’s right! Here’s another very important point. First, let’s rename the “obesity epidemic”. Let’s call it the “processed food epidemic” or the “ill health epidemic.” Obesity is usually just the most visible symptom of a much larger problem.

As Fed Up points out, there are “skinny” fat people who are just as unhealthy. So why do we call this problem an obesity epidemic? It’s about health not size.

What is Gluten? Setting the Record Straight for Celiac Awareness MonthBy Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

WE LOVE THE Jimmy Kimmel video titled ‘What is Gluten?’! In case you missed it, we’ll give you a quick recap. A reporter over at Jimmy Kimmel asked a number of people if they were on a gluten free diet. They all answered yes, yet could not define gluten. That’s right, people are avoiding gluten but they have no idea what it really is or is not. While the video clip hits on the lack of food and nutrition knowledge of many Americans, EALM feels it is necessary to educate the public! So here you go!

Gluten is made up of two proteins known as gliadin and glutenin. Gluten is the “glue” that holds most baked goods together and is found in wheat, rye, barley, and contaminated oats. While it may seem easy to some to cut gluten out of your diet, gluten has a way of sneaking into foods unnoticed.

FODMAPS: A Look at their Role in Managing IBSBy Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

Can you recall the last time you felt bloated, gassy, abdominal cramping, diarrhea or constipation? For most people, these symptoms are mild and once in a blue moon, but for people with Irritable Bowel Syndrome (IBS), there is no cure for this gut disorder and these symptoms are chronic issues that can disrupt the quality of life. The great news is that you can help manage your symptoms through nutrition!

When people think of gut symptoms like those mentioned above, one of the most common suggestions is limiting irritating food triggers like caffeine, alcohol, and fatty foods, as well as increasing fiber intake and fluid intake. However, when dealing with IBS, since these gut symptoms are broad and can vary from person to person, managing them with a one-size-fits all approach is not ideal. While there are various treatment suggestions for those suffering from IBS, following a low-FODMAP diet is the new nutrition therapy approach in town that has the potential to manage symptoms in most people with IBS.

Last month, we were fortunate enough to attend the Nutrition Grand Rounds at New York-Presbyterian Hospital to learn more about FODMAPs and their potential benefits in the treatment of IBS. The presentation featured two speakers Dr. Julie Khlevner, M.D., an expert in pediatric gastroenterology who oversees the new Pediatric Gastrointestinal Motility Center at NewYork-Presbyterian/Morgan Stanley Children’s Hospital, and Patsy Catsos, MS, RD, LD, author of the book IBS – Free at Last!. While Dr. Khlevner and Patsy both discussed treatment options for people with IBS, each speaker touched on very different areas and treatment options. Dr. Khlevner explained the process of testing, diagnosing and treatment in children and young adults. In terms of treatment options, Dr. Khlevner suggested keeping a food log, keeping an eye on trigger foods, taking probiotics, as well as IBS hypnotherapy. Patsy educated the audience on a food-based approach to treating IBS and the potential benefits of this dietary therapy.

Patsy Catsos explained dietitians play a starring role in the management of IBS. A high fiber intake has been a common recommendation for treating IBS symptom management, however, research has found that few people find the increased fiber to be helpful. Thankfully the use of FODMAPs has been becoming increasingly popular in the management of IBS symptoms and with a relief in symptoms. In fact, evidence has shown a FODMAP-elimination diet to reduce symptoms in 3 out of 4 people with IBS1.

What is IBS?

To start, lets give a background on Irritable Bowel Syndrome. IBS is classified as a Functional Gastrointestinal (bowel) Disorder and can consist of a variety of symptoms. Dr. Khlevner explained the symptoms as the “ABCs of IBS” –

Abdominal pain or discomfort

Bloating, flatulence

Change in bowel habit

Stool urgency or straining

Incomplete evacuation

These symptoms often greatly impact a patient’s quality of life, especially in children and adolescents. Treatment for IBS can vary greatly per patient; however, common treatment options can include the use of probiotics, increased fiber intake, pharmacological interventions, psychological therapy, and lifestyle and dietary modifications.

What is a FODMAP?

FODMAPs are short-chain carbohydrates that tend to be malabsorbed in people with IBS and can trigger or exacerbate symptoms. FODMAP is an acronym that stands for:

The origination of IBS symptoms can, too, be caused by a number of factors, some including, chemicals found in packaged foods, such as nitrates or sulfites, as well as FODMAPs. The ingestion of FODMAPs are not the cause of IBS, rather what can trigger the troublesome symptoms like abdominal pain or bloating. Patsy spoke about the use of FODMAP elimination trials in patients with IBS. This idea behind FODMAPs is that when people with IBS consume sugars that their body can’t properly breakdown, it contributes to their symptoms. The FODMAP approach includes a 1-2 week elimination of all FODMAPs, which Patsy called the Elimination Phase. The FODMAPs are then reintroduced into the diet one at a time to allow for proper monitoring of the patient’s tolerance. It can help you determine which sugars you may be sensitive to, and what foods to limit in quantity or what foods to avoid altogether.

Many foods contain FODMAPs and they may be very hard to avoid. You’ll likely find hundreds of food lists and suggestions of foods to avoid, which can lead to both confusion and restriction. Because of this, it’s very important to understand that the FODMAPs approach is not recommended for everyone to follow and is certainly not a weight loss diet or a cleanse, but a nutrition therapy that has the potential to help people with IBS figure out what foods trigger symptoms (…because let’s face it, constant bloating and gas isn’t fun for anyone or anyone around you!). If you’re still unsure about how to treat or manage your IBS symptoms, speak with your doctor, your dietitian, and/or check out the resources below:

And yes, there is an app for that! The research team at Monash recently launched a smartphone application: The Low FODMAP Diet. The app provides a list of hundreds of foods using traffic light signals i.e., (Red = Avoid and Green = Eat without fear) and according to serving sizes since smaller portions may be better tolerated.

If there is one thing working against us when it comes to aging it’s..…TIME. It is true that as we get older, we age. While we can’t turn back time, we can try to keep our bodies as healthy as possible to help us feel better, stronger, and more energized. Here are three of our favorite books that discuss diet, health, and lifestyle recommendations that can help you feel younger by keeping your mind and body in a state of wellness:

This book describes the aging process in a fun, easy-to-read way. It does an excellent job of intertwining medicine and nutrition. It has tons of useful tools like the YOU Tool 2 “Ultimate Work Up”-a fantastic list of tests you should be sure to inquire about at your next doctor’s visit. You also offers a 14-day plan that includes dietary changes, exercise routines, meditation, and relaxation plans. This book reminds you that caring for the mind and body together are equally important. It also includes interesting little known facts. For example Roizen and Oz note that you should remove your dry-cleaned clothing from the plastic-wrap, as soon as you get home to prevent the chemicals from becoming trapped. There is a great chapter on other toxins that you may find in your environment as well. I am going to head to my closet right now to remove the plastic from my dry-cleaning.

In Younger Next Week , my colleague registered dietitian Elisa Zied points out that crash dieting is not the solution to aging. In fact she explains that crash dieting increases cortisol levels, leading to both weight gain and aging! Zied’s 7-day vitality plan offers manageable ways to make permanent lifestyle changes that can lead to improved health and wellness. This plan is supposed to be repeated weekly so that it eventually becomes a lifestyle. Elisa states “it’s about finding a sustainable balance in your food and food choices” (Page 189). Finding balance, not only in food choices, but also in our schedules is important. Elisa offers countless examples of structured meal plans, tasty recipes, and creative “stressipes” to get you started on living a more balanced life. I am really excited to try Strawberry-Walnut Cinnamon French toast (Page 216) for breakfast next weekend!

This book may look intimidating at first, but when you crack it open it has some very practical advice. Eat, Drink, and Be Healthy: Harvard Medical School Guide to Healthy Eating is one of my favorites! Dr. Willett provides a review of some of the quick-fix diets and why they do not work. He also includes his own version of the USDA pyramid, which I find to be very useful. This is a great book if you want to learn about nutrition science. This book focuses more on the diet component of lifestyle changes and includes some really wonderful recipes, menus guides, and cooking tips to help you feel comfortable trying new ingredients. This book may be a little more of challenging read than our other two recommendations, but it is certainly worth it.

Ultimately these books can aid the work you are doing with your RD and/or MD. Remember to help yourself feel your best, make small daily changes in your life. Think balance not CONTROL! Aim for the middle ground – “The Grey Zone” – the healthy diet mentality should steer clear of black and white, all or nothing thinking. Healthy diets are learning which foods work for you. Try to think of these foods as “everyday” foods and “sometimes” foods, when meal and snack planning. Choose to exercise to help your bodies physically and mentally, not just to lose weight. Take time to relax – again both physically and mentally!! Oftentimes quick fixes may be appealing when trying to become healthy, but this typically ends up backfiring. Instead, consider taking small manageable steps, such as meditating for one minute each night, to achieve permanent behavior change.

Want more information on nutrition and aging? Check out this recently published article by the Nutrition Society:

Prostate cancer is the second most common cancer among males, following skin cancer. It is currently most common in men over 50 years of age. An estimated 1 in 5 men will be diagnosed with cancer. Prostate cancer involves the prostate, an organ associated with the male reproductive system. We spoke last week about breast cancer and wanted to continue to raise the awareness of our EALM readers by covering the ins and outs of prostate cancer; including nutritional and lifestyle recommendations to benefit the health of men.

photo courtesy of Cleveland Clinic

Causes and Contributing Factors:

As of now, the medical community has no knowledge of a definitive cause of prostate cancer. However, the American Cancer Society has highlighted some documented risk factors:

Prostate cancer is more common in men over the age of 50. And about 6 in 10 cases of prostate cancer are found in men over the age of 65.

It has been suggested to run in families. In fact, having a brother or father with prostate cancer more than doubles a man’s risk of developing prostate cancer himself.

Some studies have suggested that inherited mutations of the BRCA1 or BRCA2 genes (seen in families with higher risks of breast and ovarian cancers) may increase the risk in some men. Though these genes most likely account for a smaller percentage of prostate cancer cases.

Diet and Lifestyle:

It remains unclear how big of an effect diet has on the development of prostate cancer, although a large number of studies have found that diets higher in red meat intake, dairy products and diets high in total fat increase a man’s chance of getting prostate cancer. A study performed in Canada found that a diet high in saturated fat was associated with a “3-fold” risk of death following a prostate cancer diagnosis[i] when compared to a diet low in saturated fat[ii].

Conversely, diets consisting of fiber-rich foods, lycopene (found in tomatoes), and cruciferous vegetables have been shown to be associated with a lower risk of developing prostate cancer. It is important to note that lycopene is more easily digested after cooking, so look for recipes with cooked tomatoes like homemade marinara sauce, tomato soup, and ratatouli. Fish and intake of foods high in omega 3 fatty acids, have been linked to a decreased risk of death and recurrence of prostate cancer[i]. A recent article published in the Chicago Tribune states “men with early stage prostate cancer may live longer if they eat a diet rich in heart-healthy nuts, vegetable oils, seeds, and avocadoes”[iii]. It is because the heart-healthy fats found in nuts and vegetable oils increase antioxidants, which act to protect against cell damage and inflammation[iii].

Eating a very high amount of fruits and vegetables per day, 5-9 servings is ideal and focus on foods darker in pigment, as those tend to be higher in antioxidants.

Specifically cruciferous vegetables like broccoli, cauliflower, and kale, as they have been found to have cancer-fighting properties.

Increasing intake of omega 3, our recommendations can be found here. However, we feel it’s important to mention that a recent study found a possible link to an increased cancer risk and the digestion of omega 3s. However, the study did not question where the omega 3s came from. Therefore, it remains unclear whether it is omega 3s from food or the omega 3s from supplements increase prostate cancer risk in men. All in all, we recommend eating natural sources of omega 3s in moderation, like eating fish and a handful of nuts a few times per week[iv].

Similar to omega 3 supplementation, medical professionals advise patients to avoid using supplements, unless authorized by their doctors. In 2012 it was found that vitamin E supplementation could actually be linked to an increased risk of prostate cancer.

Although this has yet to be definitively proven in studies, many believe that drinking 2-3 cups of green tea could help fight off cancer cells. While there is little evidence to this, we don’t think it would hurt swapping your second cup of coffee with a nice cup of green tea.

Exercise has been shown to decrease the risk of prostate cancer reoccurrence. It is recommended that men get an average of 30 minutes of exercise about 5 days per week.

What activities do you do with your family to keep healthy and active? What are your favorite recipes with lycopene, cruciferous veggies, and omegas? We especially love this Tomato Soup recipe from Cooking Light!

For more resources and information on prostate cancer, we recommend the following websites:

Breast Cancer is the most commonly diagnosed cancer in women today. It is estimated that 1 in every 8 women will be diagnosed with breast cancer in their lifetime, equaling a quarter of a million women being diagnosed each year. As many of you may know, October is Breast Cancer Awareness month. In effort to raise the awareness of our EALM readers, we wanted to highlight the importance of diet and lifestyle, on not only your overall health, but also in relation to breast cancer.

Photo courtesy of www.nationalbreastcancer.org

The Role of Diet and Lifestyle:

In a recent article featuring Mary Flynn, registered dietitian and co-author of the book “The Pink Ribbon Diet,” she states, “because the majority of breast cancer cases don’t have a genetic link, you have to conclude that lifestyle factors, including diet, play a large role.” The Academy of Nutrition and Dietetics takes a similar stance, stating that “while there is no certain way to prevent breast cancer, it has been found that leading a healthy lifestyle can help reduce your risk and boost your odds if you do get breast cancer.”

Risk Factors:

Highlighted below are the risk factors. However, we want to stress that if you find you fall under a few, or more than a few, of these categories it is important not to panic. If you are concerned, please talk with your doctor and follow the recommendations for when and how often to get mammograms. Here are risk factors provided by the Center for Disease Control:

Beginning your menstrual cycle before the age of 12

Starting menopause at a later than average age

Never giving birth

Not breastfeeding post-birth

Long-term use of hormone-replacement therapy

Family history of breast cancer

Previous radiation therapy to the breast/chest area, especially at a young age

Being overweight, especially in women of the postmenopausal age

What About Insulin?

An article written by Franco Berrino, et al., states that elevated serum insulin levels are associated with an increased risk of recurrence in breast cancer patients1. The authors also found each of the following to be associated with breast cancer incidence: high plasma levels of glucose (>110 mg/100 mL), high levels of triglycerides (>150 mg/100 mL), low levels of HDL cholesterol (<50 mg/100 mL), large waist circumference (>88 cm), and hypertension (SBP > 130 mmHg or DBP >85 mmHg). The article also states that those with both metabolic syndrome and breast cancer have the worst prognosis.1 In addition, recent research has shown significant positive associations between obesity and higher death rates for a number of cancers, including breast cancer2.

In other research, omega 3 fats (alpha-linolenic acid, EPA, DHA) have been shown in animal studies to protect from cancer, while omega 6 fats (linoleic acid, arachidonic acid) have been found to be cancer-promoting fatty acids. Flax seed oil and DHA (most beneficial from an algae source) can both be used to increase the intake of omega-3 fatty acids. DHA originating from a marine source was found to be the most efficient source. To learn more about fatty acids in your daily diet check out our blog post on Fatty Acids.2

Get a minimum of 4 hours of exercise per week – aim for a minimum of 30 minutes most days of the week for optimal health. Some experts recommend yoga to breast cancer patients, as the practice of yoga can ease anxiety, depression, and stress.

Researchers and medical professionals suggest that cancer survivors eat a variety of antioxidant-rich foods each day (since cancer survivors can be at an increased risk of developing new cancers).

Diet and Yoga and Decreasing Stress:

Regardless of whether you are an individual with breast cancer, in remission from breast cancer, or woman trying to reduce your risk, the message is to maintain an active life while consuming a largely plant based diet with a focus on consuming omega 3 fatty acids like salmon, trout and sardines. Find ways to increase your intake of fruits and vegetables such as joining a community agriculture share. Be sure to try the many different forms of yoga for a form of movement and as way to decrease stress. To help manage insulin levels, focus on eating carbohydrates, proteins and fats at each meal and two of the three at snacks. This will slow the absorption of the carbohydrates thereby preventing a high blood sugar and insulin surge. Start with small goals and build upon them each week.

What’s your favorite recipe high in antioxidants? What is your favorite way to decreases stress? Do you have a favorite app that helps you achieve optimal wellness?